Objective To investigate the functional polarization of T cells in children with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Forty five cases of OSAHS children were chosen to undergo tonsillectomy and adenoidectomy.Preoperative analyses of peripheral blood Th1 /Th2 ratio and Tc1 /Tc2 ratio were compared with those of normal children and those of postoperative 6 months for observation of the change of T cells.Th1/Th2 ratio and Tc1/Tc2 ratio were detected by flow cytometry.Results The preoperative ratio of Th1 cells in children with OSAHS was significantly lower than normal children [(9.66 ± 3.73) ％ vs (13.34 ± 4.36) ％,P ＜ 0.05],while the preoperative ratio of Th2 cells was significantly higher than normal children [(3.42 ± 1.64) ％ vs (2.53 ± 1.97) ％,P ＜ 0.05],which made the Thl/Th2 ratio lower than normal children (3.51 ± 1.53 vs 5.41 ±2.17,P ＜0.05).At the 6th month after tonsillectomy and adenoidectomy,the postoperative ratio of Th1 cells was significantly higher than preoperative ratio [(12.99 ± 3.68) ％ vs (9.66 ± 3.73) ％,P ＜ 0.05],while the postoperative ratio of Th2 cells was lower than preoperative ratio [(2.62 ± 1.88) ％ vs (3.42 ± 1.64) ％,P ＜ 0.05],which made the postoperative Th1 /Th2 ratio higher than preoperative ratio (5.15 ± 1.86 vs 3.51 ± 1.53,P ＜ 0.05).There was no significant difference in Tc1 /Tc2 ratio between the OSAHS children and normal children.Conclusions Functional polarization of T cells was abnormal in OSAHS children accompanied by the predomination of Th2 cells and the normal Tc cell polarization.Functional polarization of T cells can return to normal at the 6th month after tonsillectomy and adenoidectomy.

Objective To prepare totel glucosides in paeony(TGP) pellets by extrusion-spheronization and to optimize the formulation of TGP sustained-release pellets coated with Eudragit RS 100.Methods The TGP sustained-release pellets were prepared by mini Glatt fluidized bed coating method.The factors to influence the drug release behaviors and their properties were evaluated.Results The optimal TGP sustained-release pellet was shown significant sustained-releasing at the loading weight of copolymers of 6% and the plasticizer concentration of 10%.And the curves of cumulative drug release were fit for Peppas and Higuchi equation.Conclusion The pellets showed an obviously sustained-release effect.

Objective To approach the effects of full Marathon on striated muscle and renal function of Marathon amateurs without complaints. Methods A prospective self-paired design study was conducted. The amateurs without body discomfort, hematuria, brown urine, or persistent muscle pain within 1 week after the 2012 Xiamen International Marathon Race were enrolled voluntarily. The peripheral blood and random urine specimens of all subjects under static status 1 week before the race and after the race instantly (within 10 minutes after finishing the race) were collected to detect markers of renal function and striated muscle injury. Results Sixty-one subjects were included in the final analysis of the study with full Marathon of 42.195 km and mean race time of (297.05± 55.60) minutes. Compared with those under static status before the race, the markers of renal function including the levels of urinary N-acetyl-beta-D-glucusamidase [NAG (U/L): 64.00 (54.50, 85.50) vs. 9.50 (8.10, 11.50)], urinary β2-microspheres protein [β2-MG (μg/L): 261.00 (128.50, 1 608.00) vs. 66.60 (33.75, 123.00)], random urinary creatinine [UCr (μmol/L): 19 066.56±10 938.31 vs. 5 872.52±4 363.20] and serum creatinine [SCr (μmol/L): 129.97±25.84 vs. 97.39±14.51] immediately after the race were significantly increased (all P < 0.01); the markers of muscle injury including the levels of serum creatine kinase [CK (U/L): 864.00 (504.00, 1 644.00) vs. 164.00 (128.00, 256.00)], lactic dehydrogenase [LDH (U/L): 383.26±141.69 vs. 182.23±41.12], myoglobin [Mb (mg/L): 1 880.00 (1 080.00, 3 300.00) vs. 42.00 (36.00, 54.50)], alanine aminotransferase [ALT (U/L): 27.0 (19.5, 38.0) vs. 24.0 (15.0, 29.5)] and aspartate transaminase [AST (U/L): 52.07±25.13 vs. 28.28±11.86] were also significantly increased (all P < 0.01), and the increase in CK, Mb, and LDH were more significant. It was shown by correlation analysis that CK after race was negatively correlated with age (r = -0.352, P = 0.005) and body mass index (r = -0.271, P = 0.035), and it was positively correlated with racing time (r = 0.387, P = 0.002) and urinary β2-MG after the race instantly (r = 0.364, P = 0.004). Mb after race was negatively correlated with body mass index (r = -0.331, P = 0.009), and it was positively correlated with urinary β2-MG after the race instantly (r = 0.315, P = 0.013). LDH after race was negatively correlated with age (r = -0.275, P = 0.032) and body mass index (r = -0.377, P = 0.003), and it was positively correlated with urinary β2-MG after the race instantly (r = 0.424, P = 0.001). Conclusion Full Marathon could significantly impact striated muscle and renal function of Marathon amateurs without complaints.

To increase the rescue competency of residents, also the critical thinking, team dynamics, and the capability to handle with emergencies, Shanghai East Hospital developed a rescue course integrated with 24 standardized simulation cases learning and medical simulation education for residents training pro-gram. The instructor candidates should complete the simulation training and pass the instructor certification. Every course was monitored by the course director to ensure the teaching quality. After two and a half years of practice, it is found that the teaching of case teaching and simulation teaching is better than traditional teaching, and it plays an important role in the security of medical security.

Alzheimer's disease (AD) is a central neurodegenerative disease with still unclear pathogenesis. Recent studies have shown that axonal transport dysfuction of mitochondria may contribute to AD progression. Normal mitochondrial axonal transport mainly involves microtubules, molecular motors and connexins, while AD early pathological changes can damage mitochondrial axonal transport by interfering with these proteins: accumulated β-amyloid (Aβ) impairs the function of molecular motors; abnormally modified Tau protein reduces microtubule stability; mutant presenilin-1 (PS1) can induce phosphorylation of some related proteins by activating glycogen synthase kinase-3β (GSK-3β); all these processes can damage mitochondrial axonal transport, leading to synaptic dysfunction. This review aims to clarify the possible mechanisms of axonal transport dysfuction of mitochondria in AD and provides new ideas for AD treatment.

Purpose/Significance To explore the data model design and intelligent applications of health portrait.Method/Process The paper analyzes the current situation and problems of health portrait applications,standardizes the data collection,legislation and gov-ernance of health portrait,systematically establishes the data model of health portrait,and explores potential application scenarios for health portrait.Result/Conclusion The data model of health portrait is designed to enhance the comprehensiveness and pertinence of health portrait.The data model management system is established to improve the standardized management efficiency of the model.Two application scenarios of health portrait are summarized,namely"health management and assessment"and"accurate diagnosis and per-sonalized diagnosis and treatment",which help to improve the quality and effect of medical treatment,and meet individual health needs.

Bone marrow stromal cells (BMSCs) are a kind of stem cells with multiple differentiation potential in bone marrow.BMSCs have been widely used in tissue engineering,cell transplantation,gene therapy and organ transplantation,due to their characteristics of wide range of sources,weak immunogenicity weak,easily transfected by exogenous gene,long survival time in the host,multi-directional differentiation,etc.Cerebral ischemia is caused by neurological impairment,which is the most common cause of death and quality-of-life impairments.The clinical manifestations of the patients with cerebral ischemia are motor function failure,sensory dysfunction and abnormal mental consciousness.A large number of studies have reported that BMSCs transplantation has the therapeutic effects of body sensory and motor function recovery,and can treat ischemic stroke.BMSCs transplantation has brought new hope for the clinical treatment of ischemic cerebrovascular disease.In this paper,the recent progress in the study of BMSCs transplantation for ischemic stroke was reviewed.The mechanism,pathways,influencing factors and clinical application of BMSCs transplantation were summarized.

Objective:To evaluate the relationship between preoperative SARS-CoV-2 vaccination and postoperative delirium(POD) in the patients.Methods:A total of 938 participants of either sex, aged 50-90 yr, weighing 50-90 kg, of American Society of Anesthesiologists Physical Status classificationⅠorⅡ, with preoperative Mini-Mental State Examination score ≥24, without communication barriers, undergoing elective knee or hip joint replacement under combined spinal-epidural anesthesia from June 2020 to June 2022 in Qingdao Municipal Hospital, were enrolled. The vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation was recorded. The cerebrospinal fluid 2 ml was extracted after the puncture needle was successfully inserted into the subarachnoid space for determination of the concentrations of Aβ42, total tau protein (t-tau), and phosphorylated tau protein (p-tau) by enzyme-linked immunosorbent assay (by enzyme-linked immunosorbent assay). The Aβ42/t-tau and Aβ42/p-tau ratios were calculated. POD was assessed using the Confusion Assessment Method twice a day within 7 days after surgery or before discharge.The patients were divided into POD group and non-POD group according to whether they developed POD. The risk factors of which P values were less than 0.20 in the univariate logistic regression would enter the multivariate logistic regression analysis to investigate the relationship between SARS-CoV-2 vaccine and level of cerebral spinal fluid (CSF) biomarkers and POD. Results:Eight hundred and seventy-four patients were finally enrolled in the analysis, of which 169 patients developed POD, with an incidence of 19.3%.The results of logistic regression showed that vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation, preoperative concentrations of Aβ42 in CSF, and increase in Aβ42/t-tau and Aβ42/p-tau ratios were protective factors for POD, and preoperative elevated concentrations of t-tau and p-tau in CSF were risk factors for POD ( P<0.05). After gender, age, preoperative Mini-Mental State Examination score, years of education, history of drinking, hypertension, diabetes mellitus and coronary heart disease were added to eliminate the influence of confounding factors, the results still showed that vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation was a protective factor for POD. Conclusions:Vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation is a protective factor for POD in patients.

Objective:To investigate the application effect of venous superdrainage in repairing skin defects of wrist and hand with the flap based on ascending branch of the supracarpal cutaneous branch of ulnar artery.Methods:From July 2014 to March 2021, the clinical data of patients with hand and wrist skin defects repaired with the flap based on ascending branch of the supracarpal cutaneous branch of ulnar artery in the Emergency Department of Tangshan Second Hospital were retrospectively analyzed. According to the intraoperative venous anastomosis or not the patients were divided into venous superdrainage group(from July 2017 to March 2021) and traditional group(from July 2014 to June 2017). On the basis of the traditional method, the subcutaneous vein carried by the flap and the subcutaneous vein around the wound were anastomosed end to end in the venous superdrainage group. The donor sites in both groups were directly sutured or repaired with free partial or full thickness skin grafts. The survival of flaps in the two groups was observed after operation. Fisher’s exact test was used to compare the incidence of tension blister and pigmentation between the two groups. P<0.05 was considered statistically significant. Results:A total of 51 patients were enrolled. There were 27 patients in the venous superdrainage group, which including 18 males and 9 females, aged 18 to 57 years. The wound area after debridement ranged from 6 cm × 2 cm to 13 cm × 4 cm. There were 24 patients in traditional group, which including 15 males and 9 females, aged 20 to 61 years. The wound size after debridement ranged from 7 cm × 2 cm to 14 cm × 3 cm. In the venous superdrainage group, the flap size ranged from 7 cm × 3 cm to 15 cm × 6 cm. All the flaps survived without infection and tension blisters. During the follow-up period of 8 to 22 months, one flap showed pigmentation. In the traditional group, the area of flaps ranged from 8 cm × 3 cm to 16 cm × 4 cm. Tension blisters occurred in 5 cases of flaps due to venous reflux disorder, and the flaps survived without infection after removing some sutures at the pedicle and dressing change. During the follow-up period of 8 to 23 months, seven flaps showed pigmentation. The incidences of tension blisters and pigmentation in the venous superdrainage group were 0 (0/27) and 3.7% (1/27), respectively, which were significantly lower than those in the traditional group [20.8% (5/24) and 29.2% (7/24)] (both P<0.05). Conclusions:The use of venous superdrainage in the repair of hand and wrist skin defects with the ascending branch of the supracarpal cutaneous branch of ulnar artery flap can reduce the risk of venous reflux disorders, decrease the incidences of tension blisters and pigmentation of the flap significantly.